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26 Cards in this Set

  • Front
  • Back
EPO produced in
Interstitial Peritubular Cells
Renin produced in
Juxtaglomurelar Apparatus
Cause of EPO secretion
Renal Hypoxia
Causes of Renin secretion (3)
Na level variation
Sympathetic Stimulation
Fall in efferent art pressure
By inhibiting ACE what two effects do we prevent(2)
we prevent:

Production of Angiotensin II (reducing vasoconstriction)

Bradykinin breakdown (thus vasodilating)
The left kidney is usually higher than the right

T/F
True

the liver pushes the right one down a bit
% of cardiac output down renal arteries
20 - 25%
Detrusor contraction innervation
Parasympathetic from S2-4
Innervation for
Detrusor relaxation
+ Bladder neck contraction
Sympathetic from T10-L2

(a-adrenoreceptors)
Distal Sphincter innervation
Somatic nerves (Pudendal) S2-4
Urea Normal range
2.5 - 6.6 mmol/L
Causes of Hyperuraemia >6.6 (3 groups)
Intake (GI Haemorrhage, High protein diet,)
Production (Trauma, burns, serious infection)
Reduced excretion (Hypovolaemia (inc reabsorption), Renal Failure)
Causes of Hypouraemia <2.5 (3 groups)
Low intake (malnutrition, anorexia)
Low production (liver failure)
Inc excretion (high urine flow)
Creatinine Normal Range
60-120 umol/L
Causes of Raised Creatinine >120
High production (Rhabdomyolysis, Large Muscle Mass)
Reduced Excretion (Renal Failure, Tubular secretion competition - eg trimethoprim)
Causes of Low Creatinine <60
Small Muscle Mass
Which is a more reliable indicator of renal function...

Serum urea or Serum creatinine
Serum Creatinine

Serum urea is affected by lots of variables including protein intake, liver metabolism, etc.

Creatinine is released at an almost constant rate from muscle mass and almost completely secreted at the glomerulus. However serum creatinine only falls below normal low of 60 when GFR is reduced by at least 50% and can be misleading when muscle mass is small or large.
GFR normal range
95 - 145 ml/min/1.73m2
Nephritic Syndrome is (4)
Haematuria (brown urine)
Oedema and generalised fluid retention
Hypertension
Oliguria
Nephrotic Syndrome is
Overt proteinuria-usually > 3.5 g/24 hrs (urine may be frothy)
Hypoalbuminaemia (< 30 g/l)
Oedema and generalised fluid retention
Intravascular volume depletion with hypotension, or expansion with hypertension, may occur
Acute presentation triad of pyelonephritis
Fever
Tenderness over kidneys
Loin pain
Rare complication of acute pyelonephritis
Papillary necrosis

in which renal papillary tissue can fragment off and cause obstruction or examined on histology from urine
Kidney Stone composites (3)
Calcium 80%
Ammonium Phosphate 15%
Cytstine or Uric Acid (rare)
Risk factors Kidney Stones
Environmental - heat (low urine volumes)
Dietery - high protein, high sodium, low calcium
Investigations for kidney stone
Abdo XR (90%)
IV Urogram (delayed flow, dilated above stone)
Spiral CT
Rx Kidney stones
Morphine (10-20mg)
Advise Drink >2L/day
<4mm - bed rest, 90% spontaneous pass
>6mm - 10% spontaneous so ESWL (extracorporeal shock wave lithotripsy)